Journal Article

Estimated Cases of Blindness and Visual Impairment from Neovascular Age-Related Macular Degeneration Avoided in Australia by Ranibizumab Treatment

Wong, Tien Y., Bressler, Neil, Mitchell, Paul, Rochtchina, Elena, Dolan, Chantal, Ferreira, Alberto, Colman, Shoshana, Doan, Quan V., Danese, Mark, Osborne, Aaron

2014

Overview

Intravitreal injections of anti-vascular endothelial growth factor agents, such as ranibizumab, have significantly improved the management of neovascular age-related macular degeneration. This study used patient-level simulation modelling to estimate the number of individuals in Australia who would have been likely to avoid legal blindness or visual impairment due to neovascular age-related macular degeneration over a 2-year period as a result of intravitreal ranibizumab injections. The modelling approach used existing data for the incidence of neovascular age-related macular degeneration in Australia and outcomes from ranibizumab trials. Blindness and visual impairment were defined as visual acuity in the better-seeing eye of worse than 6/60 or 6/12, respectively. In 2010, 14,634 individuals in Australia were estimated to develop neovascular age-related macular degeneration who would be eligible for ranibizumab therapy. Without treatment, 2246 individuals would become legally blind over 2 years. Monthly 0.5 mg intravitreal ranibizumab would reduce incident blindness by 72% (95% simulation interval, 70-74%). Ranibizumab given as needed would reduce incident blindness by 68% (64-71%). Without treatment, 4846 individuals would become visually impaired over 2 years; this proportion would be reduced by 37% (34-39%) with monthly intravitreal ranibizumab, and by 28% (23-33%) with ranibizumab given as needed. These data suggest that intravitreal injections of ranibizumab, given either monthly or as needed, can substantially lower the number of cases of blindness and visual impairment over 2 years after the diagnosis of neovascular age-related macular degeneration.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acuity / Age / Age related diseases / Antibodies, Monoclonal, Humanized - therapeutic use / Australia - epidemiology / Blindness / Blindness - drug therapy / Blindness - epidemiology / Blindness - etiology / Blindness - prevention & control / Clinical trials / Computer simulation / Eye diseases / Female / Humans / Immunotherapy / Impairment / Incidence / Macular degeneration / Macular Degeneration - complications / Macular Degeneration - epidemiology / Male / Medicine and Health Sciences / Middle Aged / Modelling / Monoclonal antibodies / Older people / People with disabilities / Physiological aspects / Population / Ranibizumab / Sensitivity and Specificity / Simulation / Treatment Outcome / Vascular endothelial growth factor / Visual acuity / Visual impairment